This provider's $3.8M in total Medicare payments ranks in the 99th percentile of Orthopedic Surgery providers nationally.
Their average markup ratio of 5.46x is significantly above the specialty median of 4.7x.
Medicare payments to this provider grew 29674% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 4663% in 2015
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.
| Year | Avg Submitted | Avg Paid | Markup Ratio | Gap per Service | Total Payments | Services | Beneficiaries |
|---|---|---|---|---|---|---|---|
| 2014 | $546.38 | $63.04 | 8.67x | $483.34 | $1.6K | 25 | 25 |
| 2015 | $1.5K | $195.65 | 7.84x | $1.3K | $75.8K | 568 | 524 |
| 2016 | $2.4K | $378.25 | 6.25x | $2.0K | $333.3K | 1.6K | 1.3K |
| 2017 | $2.3K | $366.22 | 6.25x | $1.9K | $401.0K | 1.8K | 1.6K |
| 2018 | $2.3K | $364.20 | 6.25x | $1.9K | $387.0K | 1.6K | 1.4K |
| 2019 | $2.2K | $364.06 | 6.06x | $1.8K | $520.5K | 2.0K | 1.8K |
| 2020 | $2.3K | $378.60 | 5.99x | $1.9K | $505.7K | 2.3K | 1.8K |
| 2021 | $1.8K | $369.16 | 4.98x | $1.5K | $533.2K | 2.9K | 1.9K |
| 2022 | $1.8K | $376.46 | 4.70x | $1.4K | $572.7K | 2.8K | 1.9K |
| 2023 | $1.8K | $381.68 | 4.67x | $1.4K | $474.0K | 2.4K | 1.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 22612 | Fusion of lower spine bones, posterior or posterolateral approach | 471 | $556.4K | $1.2K | 4.66x |
| 22633 | Fusion of lower spine bones with removal of disc, posterior or posterolateral approach | 370 | $506.4K | $1.4K | 4.82x |
| 63047 | Partial removal of middle spine bone with release of spinal cord and/or nerves | 776 | $425.4K | $548.14 | 8.29x |
| 22551 | Fusion of spine bones with removal of disc at upper spinal column, anterior approach | 281 | $360.6K | $1.3K | 3.90x |
| 22842 | Insertion of posterior spinal instrumentation for spinal stabilization, 3 to 6 vertebral segments | 543 | $309.4K | $569.77 | 5.85x |
| 22840 | Insertion of posterior spinal instrumentation at base of neck for stabilization, 1 interspace | 272 | $158.1K | $581.17 | 5.85x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.6K | $136.2K | $83.69 | 2.86x |
| 22853 | Insertion of device into intervertebral disc space of spine and fusion of vertebrae | 684 | $135.0K | $197.30 | 7.38x |
| 22614 | Fusion of spine bones, posterior or posterolateral approach | 445 | $125.6K | $282.31 | 5.64x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 3.0K | $116.7K | $38.54 | 3.19x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 895 | $106.9K | $119.49 | 3.42x |
| 22845 | Insertion of anterior spinal instrumentation for spinal stabilization, 2 to 3 vertebral segments | 190 | $106.7K | $561.74 | 6.24x |
| 63048 | Partial removal of spine bone with release of spinal cord and/or nerves | 589 | $95.0K | $161.32 | 8.68x |
| 72100 | X-ray of lower and sacral spine, 2 or 3 views | 3.2K | $85.6K | $26.40 | 4.52x |
| 22558 | Fusion of spine bones with removal of disc at lower spinal column, anterior approach | 169 | $81.6K | $482.74 | 11.92x |
| 22846 | Insertion of anterior spinal instrumentation for spinal stabilization, 4 to 7 vertebral segments | 132 | $76.5K | $579.22 | 5.60x |
| 22552 | Fusion of spine bones with removal of disc at upper spinal column, anterior approach | 232 | $70.8K | $305.24 | 3.49x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 988 | $54.2K | $54.88 | 3.31x |
| 22634 | Fusion of lower spine bones with removal of disc, posterior or posterolateral approach | 105 | $39.8K | $378.79 | 5.99x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 276 | $32.3K | $117.19 | 2.81x |
This provider submits charges 5.46 times higher than what Medicare actually pays.
A markup ratio of 5.46x means for every $100 Medicare pays, this provider initially charges $546. This is higher than the national average.
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Last Updated: February 2026 (data through 2023, the latest CMS release)
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.
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